Improving tumor budding reporting in colorectal cancer: a Delphi consensus study

Tariq Sami Haddad, Alessandro Lugli, Susan Aherne, Valeria Barresi, Benoît Terris, John-Melle Bokhorst, Scarlet Fiona Brockmoeller, Miriam Cuatrecasas, Femke Simmer, Hala El-Zimaity, Jean-François Fléjou, David Gibbons, Gieri Cathomas, Richard Kirsch, Tine Plato Kuhlmann, Cord Langner, Maurice B Loughrey, Robert Riddell, Ari Ristimäki, Sanjay KakarKieran Sheahan, Darren Treanor, Jeroen van der Laak, Michael Vieth, Inti Zlobec, Iris D Nagtegaal


Tumor budding is a long-established independent adverse prognostic marker in colorectal cancer, yet methods for its assessment have varied widely. In an effort to standardize its reporting, a group of experts met in Bern, Switzerland, in 2016 to reach consensus on a single, international, evidence-based method for tumor budding assessment and reporting (International Tumor Budding Consensus Conference [ITBCC]). Tumor budding assessment using the ITBCC criteria has been validated in large cohorts of cancer patients and incorporated into several international colorectal cancer pathology and clinical guidelines. With the wider reporting of tumor budding, new issues have emerged that require further clarification. To better inform researchers and health-care professionals on these issues, an international group of experts in gastrointestinal pathology participated in a modified Delphi process to generate consensus and highlight areas requiring further research. This effort serves to re-affirm the importance of tumor budding in colorectal cancer and support its continued use in routine clinical practice.

Original languageEnglish
JournalVirchows Archiv : an international journal of pathology
Issue number3
Pages (from-to)459-469
Number of pages11
Publication statusPublished - Sep 2021


  • Biopsy
  • Carcinoma/pathology
  • Cell Differentiation
  • Cell Movement
  • Colonic Polyps/pathology
  • Colorectal Neoplasms/pathology
  • Consensus
  • Delphi Technique
  • Humans
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Pathology, Clinical/standards
  • Predictive Value of Tests


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